Efficacy and safety of 4% articaine with epinephrine for the anterior middle superior alveolar nerve block comparing to the computer-controlled and conventional anesthetic delivery: prospective, randomized, cross-over clinical study

Dejan Ćetković; Marija S. Milić; Vladimir Biočanin; Ivana Brajić; Dejan Ćalasan; Katarina Radović; Rade Živković; Božidar Brković

doi:10.2298/VSP170511013C

Dejan Ćetković University of Belgrade, Faculty of Dental Medicine, Institute of Anatomy, Belgrade, Serbia
Marija S. Milić University of Belgrade, Faculty of Dental Medicine, Oral Surgery Clinic, Belgrade, Serbia
Vladimir Biočanin Faculty of Pharmacy and Health Sciences, Travnik, Bosnia and Herzegovina
Ivana Brajić University of Belgrade, Faculty of Dental Medicine, Oral Surgery Clinic, Belgrade, Serbia
Dejan Ćalasan University of Belgrade, Faculty of Dental Medicine, Oral Surgery Clinic, Belgrade, Serbia
Katarina Radović University of Belgrade, Faculty of Dental Medicine, Prosthodontics Clinic, Belgrade, Serbia
Rade Živković University of Belgrade, Faculty of Dental Medicine, Prosthodontics Clinic, Belgrade, Serbia
Božidar Brković University of Belgrade, Faculty of Dental Medicine, Oral Surgery Clinic, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP170511013C

Keywords: articaine, anesthesia dental, anesthesia, local, therapy, computer assisted, nerve block, injections

Abstract

Abstract

Bacground/Aim. The efficient dental anesthesia, which is related to the clinically adequate depth, duration and the width of anesthetic field, is an important prerequisite for successful dental treatment. The aim of this study was to investigate and compare the pulpal anesthesia and cardiovascular parameters after the anterior middle superior alveolar (AMSA) nerve block with 4% articaine with epinephrine administered by conventional cartridge-syringe and computer-controlled local anesthetic delivery system (CCLADS). Methods. This controlled double-blind cross-over randomized clinical study included 38 healthy volunteers. Efficacy of pulpal anesthesia after the AMSA nerve block was evaluated by measuring a success rate, onset and duration of pulpal anesthesia, using an electrical pulp tester. The parameters of cardiovascular function (systolic and diastolic blood pressure, heart rate) were monitored noninvasively. Results. Successful pulpal anesthesia of all tested teeth was obtained in 57.9% participants with CCLADS and in 44.7% participants with conventional syringe. The onset time was not significantly different between two investigated groups. The pulpal anesthesia duration was not significantly different neither within nor between investigated groups. The systolic and diastolic blood pressures were significantly decreased in both investigated groups, in comparison with the baseline values. Heart rate significantly decreased within CCLADS from 10th to 30th minute when compared to baseline. Conclusion. The efficacy of pulpal anesthesia and safety of cardiovascular profile of 0.6 mL of articaine with epinephrine (1:100.000) delivered with CCLADS were improved in comparison to the conventional syringe delivery. Significant changes of cardiovascular function were not observed.

References

REFERENCES

Malamed SF. Techniques of regional anesthesia in dentistry. In: Malamed SF, editor. Handbook of local anesthesia. St Louis: Elsevier; 2013. p. 160–93.

Friedman MJ, Hochman MN. The AMSA injection: a new con-cept for local anesthesia of maxillary teeth using a computer-controlled injection system. Quintessence Int 1998; 29(5): 297–303.

Fukayama H, Yoshikawa F, Kohase H, Umino M, Suzuki N. Effi-cacy of anterior and middle superior alveolar (AMSA) anesthesia using a new injection system: the Wand. Quintessence Int 2003; 34(7): 537–41.

Velasco I, Soto R. Anterior and middle superior alveolar nerve block for anesthesia of maxillary teeth using conventional sy-ringe. Dent Res J 2012; 9(5): 535–40.

Lee S, Reader A, Nusstein J, Beck M, Weaver J. Anesthetic ef-ficacy of the anterior middle superior alveolar (AMSA) injection. Anesth Prog 2004; 51(3): 80–9.

Corbett IP, Jaber AA, Whitworth JM, Meechan JG. A Comparison of the Anterior Middle Superior Alveolar Nerve Block and Infraorbital Nerve Block for Anesthesia of Maxillary Anterior Teeth. J Am Dent Assoc 2010; 141(12): 1442–8.

Malamed SF. Clinical actions of specific agents. In: Malamed SF, editor. Handbook of local anesthesia. St Louis: Elsevier; 2013. p. 57–72.

Lima JL, Dias-Ribeiro E, Ferreira-Rocha J, Soares R, Costa FW, Fan S, et al. Comparison of Buccal Infiltration of 4% Articaine With 1 : 100,000 and 1 : 200,000 Epinephrine for Extraction of Maxillary Third Molars With Pericoronitis: A Pilot Study. Anesth Prog 2013; 60(2): 42–5.

Somuri AV, Rai AB, Pillai M. Extraction of permanent maxil-lary teeth by only buccal infiltration of articaine. J Maxillofac Oral Surg 2013; 12(2): 130–2.

Sharma K. Maxillary Posterior Teeth Removal Without Palatal Injection –Truth or Myth: A Dilemma for Oral Surgeons. J Clin Diagn Res 2014; 8(11): ZC01–ZC04.

Brandt RG, Anderson PF, McDonald NJ, Sohn W, Peters MC. The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis. J Am Dent Assoc 2011; 142(5): 493–504.

Heasman PA. Clinical anatomy of the superior alveolar nerves. Br J Oral Maxillofac Surg 1984; 22(6): 439–47.

Pallasch TJ. Vasoconstrictors and the heart. J Calif Dent Assoc 1998; 26(9): 668–73.